Identifying factors associated with burnout is critical in designing and implementing initiatives to reduce burnout, according to a study recently published in JAMA Network Open. As previously documented, burnout has negative consequences for physician wellness, patient care, and the healthcare system as a whole. Accordingly, reducing physician burnout will require designed initiatives, recognition, and commitment from both executives and regional institutions.
Investigators conducted 2 surveys from May 16 to June 15, 2014, and from May 16 to June 15, 2017. The survey assessed 4 domains: physician career and compensation satisfaction, physician well-being, administrative workload on physicians, and leadership and diversity content. X2 tests and t-tests were used to compare demographic distribution, level of burnout, and level of satisfaction between the 2014 and 2017 surveys. Multivariable regression was used to evaluate the association of factors with the selected outcomes.
In 2014, a total of 95.9% completed the survey, though, in 2017, 92.7% completed the survey. Respondents included 1027 men (57.9%) and 747 women (42.1%) in 2014 and 962 men (51.1%) and 759 women (40.3%) in 2017. The mean number of years since training completion was 15.3±11.3 in 2014 and 15.1±11.3 in 2017.
Between the 2 time points of the surveys, burnout increased from 40.6% to 45.6%. This increase in burnout was associated with an increase in exhaustion (from 52.9% in 2014 to 57.7% in 2017) and cynicism (from 44.8 in 2014 to 51.1% in 2017). Primary care physicians practicing in ambulatory settings were more likely to have exhaustion at both time points when compared with specialists (odds ratio [OR], 1.39; 95% CI, 1.005-1.92 in 2014 and OR, 1.42; 95% CI, 1.02-1.99 in 2017).
Compared with midcareer physicians (11-20 years since training), early-career physicians (≤10 years since training) were more susceptible to burnout (OR, 1.36; 95% CI, 1.05-1.77), although physicians in their late career (>30 years since training) were less vulnerable (OR, 0.59; 95% CI, 0.40-0.88).
One study limitation was the lack of generalization of the physician population because the study was conducted in a single academic medical center. Additionally, the burnout classification used was a dichotomous variable rather than a continuum of low to high with reported cutoff values for each classification, which may cause an overestimation of burnout rates. Also, specific information such as how the physicians plan to address the burnout was not obtained.
Burnout is influenced by the individual physician, practice, organization, and national health system. Addressing the burnout factor will require a commitment from both health care organizations and individual physicians.
del Carmen MG, Herman J, Rao S, et al. Trends and factors associated with physician burnout at a multispecialty academic faculty practice organization [published online March 15, 2019]. JAMA Netw Open. doi: 10.1001/jamanetworkopen.2019.0554